Original scientific paper

https://doi.org/10.20471/acc.2021.60.03.13

Impact of Cementless Zweymüller Stem Anteversion on Resistance to Periprosthetic Fracture in Total Hip Arthroplasty

Tomislav Čengić ; Department of Traumatology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Janoš Kodvanj ; Experimental Mechanics Laboratory, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia
Tomislav Smoljanović ; Department of Orthopedic Surgery, Zagreb University Hospital Centre, School of Medicine, University of Zagreb, Zagreb, Croatia
Petra Adamović ; Experimental Mechanics Laboratory, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia
Andrija Alerić ; Experimental Mechanics Laboratory, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia
Ivan Bohaček ; Department of Orthopedic Surgery, Zagreb University Hospital Centre, School of Medicine, University of Zagreb, Zagreb, Croatia
Milan Milošević ; University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Zagreb, Croatia
Srećko Sabalić ; Department of Traumatology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Domagoj Delimar ; Department of Orthopedic Surgery, Zagreb University Hospital Centre, School of Medicine, University of Zagreb, Zagreb, Croatia

Abstract

Total hip arthroplasty implies proper orientation of both acetabular and femoral
components with a range of 25-40° of combined anteversion. The aim of the study was to examine
resistance to periprosthetic fracture of the axially loaded cross section rectangular femoral stem (Zweymüller)
with respect to different degrees of anteversion, implanted in the artificial bone model, in
laboratory conditions. Femoral bone models with implanted femoral stems were divided into 3 groups
depending on the degree of stem anteversion (A, control group 13-17°; B, stem retroverted 0°-4°; and
C, stem anteverted 26-30°). The amount of axial load leading to periprosthetic fracture (PPFx) of the
artificial bone model was determined experimentally for each construct. The results showed that the
load at which the PPFx occurred significantly increased with the increase of the endoprosthesis anteversion
angle. In our clinical practice, we are often unable to place the acetabular component in an
ideal grade of anteversion for intraoperatively determined reasons. The results of this experimental
study suggested that increasing rectangular femoral (Zweymüller) stem anteversion lowered the risk
of PPFx. This study was limited by experimental design (laboratory conditions, artificial bone) and
should be clinically verified.

Keywords

Total hip arthroplasty; Periprosthetic fracture; Artificial bone model

Hrčak ID:

271451

URI

https://hrcak.srce.hr/271451

Publication date:

1.9.2021.

Article data in other languages: croatian

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